Kimbell, Charles A.

Kimbell, Charles A. is an individual health care provider with primary practice located at 655 S Clarizz Blvd , Bloomington IN 47401-5523. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Kimbell, Charles A. can be contacted via phone (812) 355-5890.

Contact Information

Primary practice address
655 S Clarizz Blvd Bloomington IN 47401-5523
Phone: (812) 355-5890
Fax: (812) 355-5895
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040582 Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20040582 Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 33522 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 33522 Texas

Profile Details

NPI number 1740257021
LBN Legal business name Kimbell, Charles A.
Credentials PHD, HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2006
Last updated Oct 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740257021 NPPES
Other 000000316234 ANTHEM
MEDICAID 100332490A ANTHEM

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